Healthcare Provider Details

I. General information

NPI: 1285095810
Provider Name (Legal Business Name): KATHRYN ALLEN THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CROSSROADS PLZ
WEST HARTFORD CT
06117-2470
US

IV. Provider business mailing address

10 CROSSROADS PLZ
WEST HARTFORD CT
06117-2470
US

V. Phone/Fax

Practice location:
  • Phone: 860-508-5133
  • Fax: 860-231-7033
Mailing address:
  • Phone: 860-508-5133
  • Fax: 860-231-7033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN R ALLEN
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 860-508-5133